Nimura Y, Hayakawa N, Kamiya J, Maeda S, Kondo S, Yasui A, Shionoya S
First Department of Surgery, Nagoya University School of Medicine, Japan.
Br J Surg. 1991 Jun;78(6):727-31. doi: 10.1002/bjs.1800780629.
Twenty-nine patients with advanced carcinoma of the bile duct or gallbladder underwent combined portal vein and liver resection. Segmental excision of the portal vein was performed in 16 cases and wedge resection of the vessel wall in 13. The operative mortality rate was 17 per cent. The median survival for the 24 patients who left hospital was 19.8 months. Actuarial survival rates at 1, 3 and 5 years for all 29 patients were 48 per cent, 29 per cent, and 6 per cent respectively, whereas the median survival for 46 patients with unresectable carcinoma was 3 months and the 1 and 3-year actuarial survival rates were 13 per cent and zero respectively. This difference in survival times between patients undergoing hepatectomy with portal vein resection and those with unresectable carcinoma were statistically significant (P less than 0.01). Combined portal vein and liver resection is recommended as a reasonable surgical approach in selected patients with advanced carcinoma of the biliary tract.
29例晚期胆管癌或胆囊癌患者接受了门静脉和肝脏联合切除术。16例行门静脉节段性切除，13例行血管壁楔形切除。手术死亡率为17%。24例出院患者的中位生存期为19.8个月。29例患者1年、3年和5年的精算生存率分别为48%、29%和6%，而46例不可切除癌患者的中位生存期为3个月，1年和3年的精算生存率分别为13%和0。接受门静脉切除肝切除术的患者与不可切除癌患者的生存时间差异具有统计学意义（P<0.01）。对于选定的晚期胆道癌患者，建议采用门静脉和肝脏联合切除术作为合理的手术方法。
